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In Sound, again, a knack was issued for interracial out high school age guarantees. From December 1, , to January 1, , we contacted the five hookup sites by e-mail and telephone that were most commonly reported by our patients. We requested pricing estimates for advertising, including promoting information about HIV testing and treatment, PrEP and postexposure prophylaxis, and other prevention messaging. Our inquiries focused on pricing for various advertising options, including banner advertisements, bulk e-mails, and pop-up advertisements.

This term refers to the percentage of all online content and conversations for a message relative to other messages. Some companies base pricing on share of voice, while others base pricing on CPM.

Demographic and clinical characteristics of study respondents newly diagnosed with HIV, Rhode Island, Percentages may not total to due to rounding. Pricing and services offered by these five hookup sites varied widely.

Only Craigslist and Scruff provided mechanisms for free public health advertising, either for all public health organizations Craigslist or for selected nonprofit organizations on an application basis Scruff Table 2.

Scruff had a formal CSR policy readily accessible to the public and was the only site with a formal program for free public health advertising for nonprofit organizations. Characteristics of hookup websites and apps used by newly diagnosed HIV-positive men who have sex with men, Rhode Island, Cost per thousand impressions is a metric used to price the cost per number of consumer views of messages; this term refers to the total price of advertising per 1, views.

Advertise with Grindr [cited Dec 30]. Benevolads [cited Dec 30]. Craigslist [cited Dec 30]. Grindr offered paid advertising at discounted rates for nonprofit organizations. Grindr also offered broadcast messaging, or pop-up text advertisements, viewable at first login to the mobile app. Grindr did not offer e-mail advertising Table 2. Manhunt offered advertising at a lower contract minimum to nonprofit organizations than rates for corporate advertisers. Manhunt did not offer pop-up advertising on desktop or mobile devices.

Adam4Adam did not respond to multiple inquiries about advertising prices. Frequent use of hookup sites among newly diagnosed MSM, many of whom presented to care with an AIDS diagnosis, underscores the importance of disseminating prevention and treatment messaging online. Although partnerships between health-promotion agencies and hookup sites offer an opportunity to reach high-risk MSM, we encountered challenges in communicating with companies.

For example, one company did not respond to multiple inquiries about pricing and CSR programs. Although Craigslist offers free advertising and Scruff moved toward a free advertising model for selected organizations following an application process, many companies' current prices may be prohibitively high for health-promotion agencies and may present barriers for disseminating prevention messaging.

Given the frequent role of hookup sites for meeting sexual partners among newly diagnosed MSM and their potential association with HIV and other sexually transmitted infection STI risks, health-promotion agencies should do more to engage hookup companies in promoting prevention efforts.

Since we completed data collection, several companies' policies and programs related to disease prevention and sexual health have evolved. Grindr subsequently announced it would list maps and resources to help Grindr users identify local PrEP providers. In , Scruff commenced its Benevolads advertising program, which is marketed as free, geo-targeted advertising for nonprofits to create, publish, and track data on the reach of advertisements directed toward the MSM community.

Improved and expanded engagement in HIV prevention will require increased spending on messaging by private and public sectors. Our findings suggest that hookup sites already reach populations at highest risk, and public health partnerships should capitalize on this opportunity to promote prevention messaging as well as enhanced screening and treatment services.

Implementation science should explore various approaches. Given that most users visit hookup sites with the express purpose of identifying sexual partners, prevention messaging that leads with sex-positive information may resonate more with users than messages that lead or focus exclusively on risk reduction. Communication strategies that support companies' business goals while appealing to their users and allowing for delivery of important prevention messaging are needed.

It may also be important to promote messages that stimulate demand for screening and treatment services at local clinics. Further research is needed to explore which messages resonate most with consumers and respond to their sexual health needs; this research will require collaboration across sectors, including government agencies, hookup sites, users, and researchers.

Our results suggest a need for broad-based CSR programs that focus on reducing disease transmission among MSM using hookup sites. The tobacco, soft drink, and alcohol industries have almost universally adopted CSR programs in response to consumer demands. Additionally, advertising prices for many companies might be prohibitively high for health promotion.

As part of CSR policies, companies should implement deep discounts for advertising for government and nonprofit agencies whose missions are related to health promotion. This study was subject to several limitations. Patient interviews relied on self-reported behaviors. To help mitigate recall bias, we encouraged respondents to comment on how they met sexual partners in the previous 12 months.

Our results may be subject to recall bias, particularly when we asked individuals who were diagnosed late in the course of their disease where they met the partner who may have infected them. We also did not ask about frequency of hookup site use and associated coital frequency, which limited our ability to link HIV transmission to specific hookup sites.

Additionally, because we were focused on the hookup sites reported by participants rather than sites used by MSM nationwide, it is unclear how representative our findings may be for the broader MSM community. Lastly, between the time we collected data and the time the study was published, company policies and app use may have changed, particularly given the rapid pace of change in apps. We nevertheless believe that our findings suggest important and timely opportunities to enhance HIV prevention by partnering with online sites.

Although multiple factors contribute to higher rates of HIV among MSM, including social stigma and other complex behavioral and social factors, most newly diagnosed MSM in Rhode Island met one or more recent sexual partners online. Results from this study suggest that hookup sites' digital platforms may present opportunities for social marketing programs focused on reducing HIV transmission and engaging HIV-positive men in care earlier in the course of their infection.

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